Senior Pharmacy Network Configuration Analyst - Remote

Overview

Abarca is igniting a revolution in healthcare by redefining pharmacy benefits with smarter technology. As a Senior Pharmacy Network & Pricing Configuration Analyst, you will be responsible for supporting pharmacy network participation and pricing configuration in the PBM environment.

In Short

• Serve as primary support for pharmacy network and pricing configuration.
• Configure and maintain pricing logic for accurate claims adjudication.
• Support configuration changes across multiple lines of business.
• Perform unit testing and Quality Control reviews.
• Research and resolve claims adjudication issues.
• Provide first-tier triage support for claims processing issues.
• Collaborate with various teams for accurate network solutions.
• Stay current with Medicare and Medicaid regulatory requirements.
• Support onboarding and knowledge transfer through documentation.
• Evaluate workflows for process improvement opportunities.

Requirements

• Associate or bachelor’s degree or equivalent work experience.
• 6+ years of experience in PBM Pharmacy Network & Pricing configuration.
• 2+ years of experience using SQL and Excel.
• Strong analytical skills for identifying network/pricing issues.
• Ability to collaborate across technical and operational teams.
• Excellent oral and written communication skills.
• Flexible hybrid work model with certain on-site workdays required.
• Availability for on-call hours as needed.

Benefits

• Flexible hybrid work model.
• Diversity, equity, inclusion, and belonging initiatives.
• Equal employment opportunities.
• Supportive work environment.